What is it about?
Patients with preoperative low left ventricular ejection fraction (LVEF) are known to be associated with high morbidities and mortality in cardiac surgery. The primary aim of this review was to examine the clinical outcomes of levosimendan versus placebo in patients with preoperative low LVEF≤50% undergoing cardiac surgery.
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Why is it important?
Given the low level of evidence and inconclusive TSA, the results of this meta-analysis neither support nor oppose the use of levosimendan in cardiac patients with preoperative low LVEF≤50%. Therefore, multi-centre, adequately powered, randomised controlled trials are warranted.
Perspectives
This meta-analysis suggested that levosimendan was associated with a significant reduction in mortality (overall), especially in the subgroups of patients with severe low preoperative LVEF ≤30%, who were administered levosimendan preoperatively, and among patients who received bolus followed by infusion of levosimendan. Our TSA showed that it was still premature to draw firm conclusion from this meta-analysis as it was based on inadequate data.
Dr Ka Ting Ng
University of Malaya
Read the Original
This page is a summary of: Levosimendan use in patients with preoperative low ejection fraction undergoing cardiac surgery: A systematic review with meta-analysis and trial sequential analysis, Journal of Clinical Anesthesia, February 2019, Elsevier,
DOI: 10.1016/j.jclinane.2018.08.019.
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